Does Family Planning Reduce Abortion The Latest Evidence

1
Does Family Planning Reduce Abortion?The Latest
Evidence

• Scott Radloff, USAID
• GH Mini-University
• May 10, 2004

2
Overview

• Reducing abortion is a principal objective for
  FP/RH in EE
• Abortion rates in EE are among the highest in
  the world
• USAID provides roughly 20 million per year for
  FP/RH programming in EE

3
Key Concepts

• Total Fertility Rate
• Total Abortion Rate
• Total Pregnancy Rate
• Modern CPR
• Traditional CPR
• Unmet Need

4
The total abortion rate and the prevalence of
modern contraceptive methods in 18 countries
Georgia
Azerbaijan
Armenia
Romania
Belarus
Bulgaria
Kyrgyzstan
Kazakhstan
Russia
Moldova
Hungary
Turkmenistan
From Westoff, 2003
r -.92
5
The total abortion rate and the prevalence of
traditionalcontraceptive methods in 18 countries
Bulgaria
Turkmenistan
r .55
From Westoff, 2003
6
Recent trends in modern contraceptive use and
abortions for all women.
From Westoff, 2003
7
Recent trends in modern contraceptive use and
abortion
From Westoff, 2003
8
Family Planning Demand By Country with Percent of
Pregnancies Ending in Abortion
42
60
40
60
15
23
31
63
69
Percent of MWRA
9
Total Fertility and Abortion Rates By Country
with Modern CPR
12
20
49
22
51
53
53
30
50
10
Georgia
Azerbaijan
Romania
Armenia
Moldova
Kazakhstan
Kyrgyzstan
Turkmenistan
Uzbekistan
Adj r2 .738
11
Kazakhstan 1999 Demand by Wealth Quintile
Percent of MWRA
12
Kazakhstan 1999 Total Fertility and Abortion
Rates by Quintile with Modern CPR
49
51
55
53
55
13
Armenia 2000 Modern CPR by Quintile
14
Armenia 2000 Total Fertility and Abortion Rates
by Quintile with Modern CPR
16
21
22
22
29
15
Summary

• Abortion rates are highest where MCPR is lowest
• Traditional methods are less protective
• Abortion rates are falling where MCPR is
  increasing
• Percent of family planning need satisfied is
  highly and negatively correlated with percent of
  pregnancies ending in abortion   

16
Summary (cont.)

• Wealth quintile analyses reveal important
  differences
• Kazakhstan  in MCPR, h TFR among poorer, h
  abortion among wealthier
• Armenia  h MCPR among wealthier, in TFR, h
  abortion among poorer

17
Reasons for Not Using Modern among Traditional
Method Users Georgia 1999
18
Thank you!

• Questions
• Programmatic Implications

19
Armenia 2000
All Women 15 44
1,000
Using Contraception 402
Not Using Contraception 598
In Need 88
Low Risk 142
Seeking Pregnancy 53
Never Had Sex 315
Modern Method 150
Traditional Method 252
10
50
61
8
35
0
7
41
24
6
3
0
Abortions per 1,000 Women 15 44
81
20
Figure O. Percent reductions in abortion rates
if all unmet need and all traditional method use
shifted to modern methods
21
Figure I. Mean ideal number of children, by
current age of women
Uzbekistan
Kyrgyzstan
Turkmenistan
Kazakhstan
Armenia
Georgia
Azerbaijan
Turkey1
Moldova
Romania
Ukraine
1 Based on currently married women.